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Clinical and health economic evaluation of a post-stroke arrhythmia monitoring service

Muggeridge, David; Callum, Kara; Macpherson, Lynsey; Howard, Nick; Graune, Claudia; Megson, Ian; Giangreco, Adam; Gallacher, Susan; Campbell, Linda; Williams, Gethin; Macaden, Ashish; Leslie, Stephen J.


Kara Callum

Lynsey Macpherson

Nick Howard

Claudia Graune

Ian Megson

Adam Giangreco

Susan Gallacher

Linda Campbell

Gethin Williams

Ashish Macaden

Stephen J. Leslie


Atrial fibrillation (AF) is a major cause of recurrent stroke and transient ischaemic attack (TIA) in the UK. As many patients can have asymptomatic paroxysmal AF, prolonged arrhythmia monitoring is advised in selected patients following a stroke or TIA. This service evaluation assessed the clinical and potential health economic impact of prolonged arrhythmia monitoring post-stroke using R-TEST monitoring devices.

This was a prospective, case-controlled, service evaluation in a single health board in the North of Scotland. Patients were included if they had a recent stroke or TIA, were in sinus rhythm, and did not have another indication for, or contraindication to, oral anticoagulation. A health economic model was developed to estimate the clinical and economic value delivered by the R-TEST monitoring. Approval to use anonymised patient data in this service evaluation was obtained.

During the evaluation period, 100 consecutive patients were included. The average age was 70 ± 11 years, 46% were female. Stroke was the presenting complaint in 83% of patients with the other 17% having had a TIA. AF was detected in seven of 83 (8.4%) patients who had had a stroke and one of 17 (5.9%) patients with a TIA. Health economic modelling predicted that adoption of R-TEST monitoring has a high probability of demonstrating both clinical and economic benefits.

In conclusion, developing a post-stroke arrhythmia monitoring service using R-TEST devices is feasible, effective at detecting AF, and represents a probable clinical and economic benefit

Journal Article Type Article
Acceptance Date Feb 7, 2022
Online Publication Date May 31, 2022
Publication Date May 31, 2022
Deposit Date Jun 3, 2022
Publicly Available Date Jun 27, 2022
Journal The British Journal of Cardiology
Print ISSN 0969-6113
Peer Reviewed Peer Reviewed
Volume 29
Issue 2
Pages 46-51
Public URL
Publisher URL


Clinical And Health Economic Evaluation Of A Post-stroke Arrhythmia Monitoring Service (Figures 1-3) (220 Kb)

Clinical And Health Economic Evaluation Of A Post-stroke Arrhythmia Monitoring Service (accepted version) (89 Kb)

Copyright Statement
Copyright of Medinews (Cardiology) Limited. Full citation: Callum K, Muggeridge DJ, Giggins OM et al. Clinical application of physical-activity monitoring in patients with CIEDs Br J Cardiology 2020;27:115-8. doi:10.5837/bjc.2020.035

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